Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $169.82 / $6,606.93	Facility		$100.00	$169.82	$6,606.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $31.62 / $117.49 / $117.49	Facility	50	$31.62	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $100.00 / $309.03	Professional		$53.70	$100.00	$309.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $104.71 / $173.78 / $776.25	Professional	50	$104.71	$173.78	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $120.23 / $199.53	Professional		$70.79	$120.23	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $128.82 / $190.55	Professional		$83.18	$128.82	$190.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $107.15 / $213.80	Facility		$64.57	$107.15	$213.80
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $31.62 / $31.62 / $117.49	Facility	50	$31.62	$31.62	$117.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $138.04 / $204.17	Professional		$83.18	$138.04	$204.17
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $141.25 / $177.83 / $616.60	Professional	50	$141.25	$177.83	$616.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $144.54 / $190.55	Facility		$125.89	$144.54	$190.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $107.15 / $190.55	Facility		$64.57	$107.15	$190.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $131.83 / $194.98	Professional		$79.43	$131.83	$194.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $933.25 / $1,122.02	Facility		$741.31	$933.25	$1,122.02
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $1,096.48 / $1,412.54 / $1,698.24	Facility	50	$1,096.48	$1,412.54	$1,698.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $141.25 / $194.98	Professional		$100.00	$141.25	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $1,513.56 / $6,165.95	Facility		$389.05	$1,513.56	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $125.89 / $194.98	Professional		$81.28	$125.89	$194.98